Sex Med Advocate and ISSWSH President - Sue Goldstein Sue Goldstein is an AASECT certified sexuality educator and certified clinical research coordinator. She serves as clinical research manager and program coordinator for San Diego Sexual Medicine  Thanks to our sponsor Sprout Pharmaceuticals addyi.com/notbroken  Thanks to our sponsor Uber Lube 10% off, Code NOTBROKEN  uberlube.com  She is current president of ISSWSH (International Society for the Study of Women’s Sexual Health)  Her story of your career in sexual education and sex med.  Pain associated with oral contraceptives.  There should never be pain with sexual activity.  We pick apart “doing menopause naturally”  We discuss PGAD Persistent Genital Arousal Disorder and the role of education for people and providers. Language matters.  We talk about menopause and pain with sex after menopause.  Is low sex drive the “tip of the iceberg” for testosterone?  We discuss testosterone, SHBG and bioavailable testosterone and explain how this works.  What is a vajay-jay?  The importance of using correct words for our anatomy.  Why we love ISSWSH.  Why Sue hates the concept that “women are complicated”   The combo platter of aging PIV intimacy – we need to approach both partners to address the issues.   Sue shares her experience with HSDD  We discuss the issue with delayed ejaculation.   “The educated woman is the empowered woman” – Sue Goldstein   https://www.isswsh.org/ ISSWSH’s Education website https://www.prosayla.com/   Book about vulvas: Petals by Nick Karras   Sue’s Book: When Sex Isn’t Good https://amzn.to/3OKyMMk   Did you get my “You Are Not Broken” Book Yet? https://amzn.to/3p18DfK Listen to my Tedx Talk: Why we need adult sex ed   Join my NEW Adult Sex Ed Master Class: https://www.kellycaspersonmd.com/adult-sex-ed  Join my membership to get these episodes ASAP when they are created and without advertisement and even listen live to the interviews and episodes. www.kellycaspersonmd.com/membership --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message

GOAT - Dr. Irwin Goldstein He is the director of San Diego Sexual Medicine. Dr. Goldstein has had a long career providing medical help to those with sexual problems, having been involved with sexual dysfunction research since the late 1970′s. Dr Goldstein’s interests include regenerative therapies for men and women, surgery for dyspareunia, physiologic investigation of sexual function in men and women, and diagnosis and treatment of sexual dysfunction in men and women. He has authored more than 360 publications in the field of sexual dysfunction, with 20 consecutive years of funding by the National Institutes of Health   Thanks to our sponsor Sprout Pharmaceuticals addyi.com/notbroken  Thanks to our sponsor Uber Lube 10% off, Code NOTBROKEN  uberlube.com  You are a urologist. I am a urologist. You are a pioneer and yet I don’t even remember hearing about you during residency training. How do urologists not know who Irwin Goldstein is? He started out in men’s sexual health. Dr. Goldstein tells us his story. Dr. Goldstein published the original paper on Sildenafil (Viagra) – and 90% of the phone calls after were women asking for help for them. He created ISSWSH. https://www.isswsh.org/ He was in the room when the term vulvovaginal atrophy was changed to genitourinary syndrome of menopause (GSM). Thoughts on DHEA vaginally. Women and Sildenafil – oral versus topical and his thoughts on arousal. Orgasm guidelines are coming!! The role of dapoxetine (Priligy) for inability to orgasm – you can’t get this in the USA Other drugs for orgasm The role of testosterone for orgasm issues Sexual side effects of birth control pills Depression side effects of birth control pills Testosterone in women! It is a thing! Estradiol in men – needed for bones and erections. We wrap up with discussing hard flaccid. A hypogastric nerve dysfunction. Any advice for me, for other physicians, for the women and their partners? --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message

Mojo and Empowerment with Deborah Kagan Thanks to our sponsor Uber Lube 10% off, Code NOTBROKEN  uberlube.com  Deborah Kagan helps women conquer self-doubt and indecision to step into their full power, love who they are and live a turned ON life.  She tells us her inspiration and her story. How do we get women to thinking differently?  Our bodies are energy and the concept of male and female energy.  The four pillars of Deborah’s teaching about MOJO.  What is Mojo and how is it different from libido?  How do you know if you are disconnected from your body?  We discuss masculine and feminine energy.  We discuss our thoughts about the Barbie movie.  Feeling feelings and using anger for us.  We discuss your intuition, your gut intuition and where your mojo lives.  We discuss pain and the role of Western medicine and the role of our energy and listening to our body and our relationship with our body.   The Real Undressed Podcast: https://podcasts.apple.com/us/podcast/the-real-undressed-with-deborah-kagan/id1494643770 Order Undressed Now Find her on https://www.facebook.com/mojorecoveryspecialist Instagram (@deborahkagan) Twitter (@deborahkagan) Pinterest (/deborahkagan) and LinkedIn (/in/deborahkagan). And for all things mojolicious, check out www.deborah-kagan.com/blog --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message

Sexual Health is an Equality Issue! – A Chat About Sex, Coaching and Menopause This was a live chat that I did with Dr. Ashley Winter. She is the Chief Medical Officer at Odela health! We had a chat about my book and sexual health in general. Is it true that women are “too complicated”? Sexual Health is an Equality Issue The clitoris doesn’t have a place in the traditional medical paradigm – Dr. Winter We don’t teach people medically accurate language – so we can’t communicate with anyone and it ends up hurting you. It is not informed consent if we don’t tell people that medications can cause sexual health issues. Everyone needs to know about menopause. The reason coaching really helps our sex lives. The fallacy of “natural” and challenging the idea that natural is better. We need to stop judging women for their decisions around hormones. We don’t judge men for being on testosterone. The problem with the FDA label on vaginal estrogen. Love Dr. Winter? Go way back to episode 46 https://www.odelahealth.com/ Did you get the You Are Not Broken Book Yet? https://amzn.to/3p18DfK Did you watch the Tedx Talk yet? Why We Need Adult Sex Ed   Join my NEW Adult Sex Ed Master Class: https://www.kellycaspersonmd.com/adult-sex-ed   Join my membership to get these episodes ASAP when they are created and without advertisement and even listen live to the interviews and episodes. www.kellycaspersonmd.com/membership --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message

Menopause and Hormones in the Modern Era AKA: Why the Boomers Should be Pissed  This is a lecture I gave for the Society of Women in Urology about hormones.  If you like this episode also check out number 197.  Genitourinary syndrome of menopause  Men at age 60 have more estrogen in their bodies then women Why I don’t do a loading dose of vaginal estrogen.  The problem with the vaginal estrogen labeling by the FDA.  How the nation used estrogen prior to the Women’s Health Initiative Scare. I explain why the WHI study was created and what question it was trying to answer. Myth: you have to be a year without a period to be on hormones.  I break down the three concerns about progestin and breast cancer from the WHI 1)  Was the placebo arm flawed 2) Was it the synthetic progestin and now we use bioidentical 3)  Maybe progestin increases risk but it is small and perhaps benefits still outweigh risk as breast cancer is so curable and all the other benefits are worth the small increased risk I discuss the “critical window” hypothesis and “healthy cell” hypothesis and why hormones are recommended to be started “early” in menopause which means less than ten years. Why I think the Boomers should be pissed. Vaginal estrogen for all and get an okay from your  Best practices -  If you have a uterus, with systemic estrogen you need a progestin -  You can continue hormones for life as long as your benefit > risks -  Vaginal bleeding after menopause is never normal -  If there is an FDA approved product use it instead of compounded -  Checking hormones is often not necessary -  One size does not fit all   What about hormones for prevention? On a national level the answer is no. But everyone needs their own analysis.  National guidelines on how to give testosterone to women for low desire. Hormones: are we being equitable to all genders in regards to hormones.   NAMS 2022 guidelines: According to NAMS, “the benefits of hormone therapy outweigh the risks for most healthy symptomatic women who are aged younger than 60 years and within 10 years of menopause onset.” For women with primary ovarian insufficiency and premature or early menopause who are at higher risk of bone loss, heart disease, and cognitive or affective disorders, “hormone therapy can be used until at least the mean age of menopause unless there is a contraindication to its use.”   Where is the black box warning on alcohol?   What about lasers for GSM?   Where are we on removing the FDA black box warning on vaginal estrogen?   My thoughts on online hormone companies.   Estrogen plays a role in the gut microbiome and may affect the risk of osteoporosis.   Our podcast sponsor today is AG1. Use AG1 to build a foundation for better health. FREE ONE YEAR SUPPLY OF VITAMIN D3+K2, 5 TRAVEL PACKS drinkag1.com/youarenotbroken   Did you get the You Are Not Broken Book Yet? https://amzn.to/3p18DfK Did you watch the Tedx Talk yet? Why We Need Adult Sex Ed Join my NEW Adult Sex Ed Master Class: https://www.kellycaspersonmd.com/adult-sex-ed Join mymembership to get these episodes ASAP when they are created and without advertisement and even listen live to the interviews and episodes. www.kellycaspersonmd.com/membership --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message